It can never be anything other than the saddest day when an elderly relative takes up residency in a nursing care home, be it 'residential' or 'nursing' category. It will hopefully be something that you have talked over with your relative in depth and you will be very fortunate if he/she has come to terms with the option without a deal of heartbreak over the situation. I hope my personal story can give others an insight into how this experience felt for me and that the insights I discovered along the way regarding nursing home care will be helpful to others considering this as an option for their elderly parents.
I was very lucky as my elderly, blind mother had always told me that this was what should happen (ie for herself to go into care when the time was right) and she was so very good at just getting on with the process when it came to the moment of departure from her flat. I'll always remember watching her take her last footstep over her doorstep and I often think, in a sense, it helped that she was blind because she did not have to 'look around for the last time' at the inside of her house or environs and this was such a tremendous relief all round.
I did not know at first that there were two categories of elderly care homes - residential or nursing - although I suppose it is self-explanatory that, if you require to be nursed or require 24 hour care, then your relative's doctor will have to approve nursing care. As my mother was blind she fell into the nursing care category. Financial details regarding living in care homes are worked out by appropriate professionals, family and care home management prior to admission and any further personal contribution depends on whether one's income exceeds a certain threshold which will vary from year to year.
I have older brothers and I explored the suggestion from one that, since there was an elderly nursing care home 'for the blind elderly' in the city where he lived over an hour's drive away, it might be an idea for her to go there since they had a vacancy ready. I thought that it would perhaps be an unselfish thing to do to let her have the best possible 'blind' care available. I thought it would give my mother the chance of enjoying life a bit more in a place that actually catered for the blind. I was prepared to make the sacrifice of distance over closeness so that she could live life to the fullest in a blind-specific environs even if it meant visiting her every weekend as opposed to every day.
I did visit the home prior to her admission (in fact, more than one visit is best recommended) and it was a lovely place with plenty of light, airy rooms but what I did not do - and take heed - is find out exactly what it was that they did for the blind that warranted the emphasis on 'blind' being in the title of the care home. I just presumed that it obviously would be better there for her on that basis, that there was bound to be much more to life for a blind person.
Sadly, it did not prove correct as I realised that, as lovely a place as it was and with very pleasant staff as well, she was no better there than if I had kept her close to me in her home town. They had nothing in place for her to be able to attract the staff's attention with ie nothing to press or ring which meant she had to resort to shouting, which in turn made her seem loud and difficult and I did not want my mother turning into a 'shouter' when the facilities should have been in place for her to be able to get attention in a blind-focused place in the first place. There were no emergency buttons or any other alerts - just bedroom doors permanently left open so that residents could be monitored or heard in passing and the lack of privacy therein did not appeal to me. I could not believe this issue was not deemed a priority in a blind-orientated place and then started to realise that, actually, there were quite a few people here who could actually see reasonably well. So, perhaps it was not quite strictly the 'blind' institution it was purported to be? The lesson is therefore, to be absolutely certain of what a nursing care home's claims are in terms of care services offered.
In short, after my mother's three month trial (which one is entitled to before taking up final residency), the social worker, care workers, my mother and myself had a meeting wherein my mother said that though she had not been unhappy here she would still prefer to go back to a care home nearer home. A place became available in a nursing care home back in her home town (which I had not been allowed to apply for previously as she had not been marked down as 'nursing' category by the doctor at time of application) however, suffice to say, we settled her in there happily. I felt I had made a great mistake by not fully investigating the facilities of the previous nursing home and really it was emotionally foolish of me to send my mother so far away when really we were closest to each other in the family and it was I that really kept her going from day to day. I can only say that, although I made this mistake, I had done it with the best of intentions but, most importantly, I rectified the situation as soon as I could.
It is worth mentioning, in general, that it is not always made clear to families of care home residents that it will very much be up to them to keep their elderly relative physically mobile ie take them for walks even if it is up and down the corridors, out in the gardens etc. It is something that became apparent to me eventually.
I was quite shocked to realise that it was not necessarily a priority to keep one's relative limber and active on the care home agenda. Please bear this in mind as it is important that your relative does not become less active (if, obviously, they had a certain level of activity and strength prior to admission) on entry into nursing or residential care because mobility is not seen as a priority, nor is there the staff time to do it you come to realise, unless the resident particularly requires physical therapy in their care package. Sadly, inactivity is destined to increase in the case of a blind elderly person unless you take on the responsibility of keeping them motivated and exercising but only if he/she is equally willing, I may add.
Staff members have many titles in a care home. For instance, do not be afraid to ask, 'What is a 'Key Worker'? Who is it? What exactly are they responsible for doing?' Ask what all the staff's remit is towards residents. Do not let anyone with a 'recovering' cold or chest infection feed your relative or be at close quarters with them and think nothing of reporting such an instance as elderly people are vulnerable to infection.
Get involved with the residential home's activities as much as you can and have regular meetings with the manager as to your relative's progress, medical and emotional. Help the staff know what is best for your relative so that they know all the little likes and dislikes and are better able to accommodate them. Make sure they look after costly things like false teeth and hearing aids, for instance, and also the laundry of clothes, paying particular attention to care of special materials. My mother liked eating her meals in her own room as she had to be fed - this is permissible and make sure that the care home will do this should your relative wish it. It may be useful to note that all residents have a private room with ensuite facilities these days.
Your relative will also have their own personal file where staff record what your relative did that day and any useful comments that arise which you are allowed to read at any time and query if necessary. It is good to note the level of involvement with activities and have staff note this down from day to day as this lets you see how much the home is accountable for quality of life.
One final piece of advice - you will always come across those who say, 'I could never put my mother/father in a home'. It is a very ignorant and hurtful thing for people to say around those who are thinking of doing so, or have done so, as they have no understanding of that person's or relative's personal circumstances, reasons and background. I will always, always feel guilty about not caring for my mother until the end of her days and will always wonder in retrospect if I could have and should have, forever. It doesn't matter what anyone tells me out of comfort.
I am certain she would have lasted a lot longer physically if she had not lost her sight - she would have been able to move more and generally have a more active and interactive life and not become less extrovert or able through lack of sight.
I was so lucky that she was always mentally alert and never had any bladder problems. I was also lucky that she always maintained vehemently that the day would come when she should go into care and even said to me that she thought she had ruined my life. She hadn't, but I grew increasingly worried for my health as I had put on a lot of weight over these years and my spirits were low with just not having much fun in my own life, added to long working days travelling to the city and back on top of tending to her last needs at night before finally getting to my own home. Although my mother had home care support during the day by then, you do nonetheless get on a treadmill of never-ending routine care, preparation and housework, even although I know that 'routine' is good and at least isn't 'ambulance' or 'hospital'.
I was also afraid of being impatient with my mother at times as, as close as we were, it is very hard to be saintly all the time with your own relative. I defy anyone to say that they don't get angry from time to time and worn out with their elderly loved ones and it worried me that I could not be happy and patient all the time. My older brothers who contributed very little to her quality of life or helped me get time off by staying at my mother's sometimes or having her stay with them. So no-one would ever be able to make me feel worse about going down this route than I already do - it may still be grief talking and time just has to take care of that.
So there it is. I honestly believed that, living alone in a top flat with no means of getting outside or guarantee of friends or other family visiting on a regular basis, my mother, as a very outgoing personality, would benefit from contributing gladly to any sing-songs, lively chat, outings and being cared for 24/7 in a care home.
I think to enter into a care home at 84 years old wasn't so bad, considering I saw residents in there who were active and much younger and wondered myself what on earth they were doing there. I have to say that I was very happy with this nursing home and I know that I made the right decision to transfer her back there. I visited my mother every day there and I figured that I was really just doing what I used to do anyway when I visited her every day at her own flat. Again, the blindness served beneficially as my mother never ever mentioned home since she could not see around herself to miss it particularly.
There were some lovely, caring staff and management there and it is important to emphasise this as there is immediately this great release of negativity surrounding care homes when brought up in conversation. The best way to allay your fears is to visit prospective care homes as often as you need to, to get a proper feel for a place and its staff - and ask plenty of questions about what is on offer for residents, talk to other family relatives of residents if you see them and get their views and match your relative's needs carefully to what is or is not provided. Take a lot of time over this. It may even be that your relative can afford to have live-in help as there are still these options.
For all my angst and guilt of my mother subsequently ending up in a nursing care home, it is certainly where I wished for her to have passed away. She contracted a chest infection, which led to pneumonia in hospital, further swallowing problems and a protracted passing away there. It could be that she would have ended up in hospital whether in a nursing care home or not and, ultimately, it shows that you can choose your actions but you cannot choose the outcome.
My last photo of my mother in the nursing home is outside on bonfire night, smiling, with her fur hat on and shouting. 'Hurrah!' at the fireworks display with, to my delight, her teeth in - just as she would have liked to have been photographed. It is the last picture I have pasted into her memory book and my mind.
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